Case 89
Gross AR
What operation would you do on this 65 year old chap referred by the cardiologists for an AVR for symptomatic severe AR, with normal coronary arteries?
He needs an aortic root replacement. If the valve is structurally normal and the mechanism of the regurgitation is sinotubular junction dilatation then a David procedure is an option, however a straight root replacement be it mechanical or biological is the best option. The only question is how far up the acendeing aorta the aneurysmal dilatation goes. A CT scan preoperatively is good for evaluating this, as the aneurysmal dilation may extend into the arch and even the descending aorta.